Provider Demographics
NPI:1851699987
Name:WILBERT, BLAIR POPE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:BLAIR
Middle Name:POPE
Last Name:WILBERT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10617 JOOR RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-3906
Mailing Address - Country:US
Mailing Address - Phone:225-262-1334
Mailing Address - Fax:
Practice Address - Street 1:11080 GREENWELL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-7001
Practice Address - Country:US
Practice Address - Phone:225-273-6525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA173571835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist